Root canal treatment: How many visits are needed? How long do appointments last?

The number of visits that it takes to complete your root canal treatment may be as few as one. With some cases, however, two or more scheduled appointments will be required.

It all depends on the way your dentist has been trained, their skill level, the equipment they have and, probably most importantly, the circumstances they find present inside your tooth.

This last factor, of course, implies that the number of needed visits will vary on a case-by-case basis. And the dentist may not be able to make this determination until after they have initiated the tooth's treatment.

• Which will be needed, one or two appointments?
• Single-visit cases - Examples.
• Multi-visit cases - Examples.
• How long will each appointment take?

It used to be that all root canal treatment followed a two-visit approach.

In the past, dentists always broke root canal therapy into two (or more) appointments.

The first appointment was primarily focused upon the task of cleaning and shaping the tooth's root canal system. The second appointment, usually scheduled about a week after the first, was used for filling and sealing the tooth's root canal system.

The thought associated with this approach was that it allowed for optimal tooth disinfection, it made managing patient comfort easier and more predictable, and it also gave the dentist an opportunity to monitor the progress of the tooth's healing process.

Nowadays, opinions about the need for multiple visits have changed.

In recent decades, the single-appointment approach to endodontic treatment has gained attention. And as a result, it has become both more popular and more controversial within the dental community.

As more and more studies evaluating the comparative success (treatment outcome, patient comfort) of multi-visit vs single-visit therapy have been performed, it has become clear that neither approach is necessarily best but instead that case selection must play the prominent role in deciding which approach is most appropriate.

Research has helped to clarify the issue.

Dental research has suggested that a primary consideration in the choice between single or multi-visit treatment should be the degree to which the tooth's root canal system harbors infection.

A) Single-appointment cases. - Examples

If the infection is limited to just a portion of the tooth's "nerve" (pulp) tissue (meaning the tooth still harbors some live pulp) then the single-visit approach makes an excellent, possibly even preferred, treatment choice.

This scenario could include teeth that require root canal treatment due to the exposure of their pulp tissue during dental treatment or tooth fracture, and teeth that are in the early stages of pulpal degeneration.

B) Multi-appointment cases. - Examples

In those cases where the entire root canal system harbors bacteria, single-visit treatment may, or may not, be an appropriate choice. This would include teeth whose pulp tissue has died (non-vital, necrotic teeth), teeth with active infections, and retreatment cases.

And as a general rule, if the patient is experiencing pain, tenderness or swelling at the time of their appointment, the dentist will be less likely to choose single-visit treatment.

They will also be more likely to choose a multi-appointment approach for complex cases because they will simply take more time to complete. This might include teeth that have multiple root canals (molars), or teeth that have canals that are generally difficult to find, access or negotiate.

How long does a root canal appointment take?

Over the last few decades, new techniques and new types of equipment have been developed. And in most cases, using them can enhance the efficiency with which a dentist is able to perform their work.

This improved efficiency can allow for appointments than are shorter in duration than were possible in the past. It is also one reason why single-visit treatment is a possibility and has become so commonplace.

As a ballpark estimate, any single root canal appointment will usually last somewhere between 30 to 60 minutes and, in some cases, possibly as long as 90 minutes.

If you, as a patient, have a preference or a need for short appointments (with the understanding that you will need to schedule more of them) you should let your dentist know. This might include people who have TMJ (jaw-joint) problems or have trouble sitting still for extended periods of time. Other patients may have a strong preference or need for longer, yet fewer, appointments.

Don't over look that additional appointments will be needed.

After your root canal treatment has been completed, you will probably need to schedule one or more subsequent appointments dedicated solely toward making a permanent restoration for the "root canalled" tooth. If the final restoration is a filling, then most likely only one appointment will be needed. Placing of a dental crown (or else a post and core and dental crown) on a tooth typically involves two or more appointments.